New Certified Produ

High-Efficiency Lavatory (Bathroom Sink) Faucet 

EPA WaterSense® Program Partners: Please complete and submit within two weeks of notification from a licensed certifying bo

product model has received the WaterSense label. By submitting this form, the manufacturer partner agrees to continue to uphold 

manufacturer partnership agreement. Manufacturer Name1: __________________________________________________________________ 

Section I: General Information Name: ________________________________ Telephone: ______________________________ Fax: ________________________________ E-mail: ______________________________ Contact Name (for questions from the EPA WaterSense Team regarding this form) Section II: Product Information 

Product 1 — Faucet or Faucet Accessory2 

Brand Name Model Name Model Number Type 

(faucet or faucet 

accessory) 

Flow type/Spray Pattern 

(aerated, laminar, spray, 

other) 

Ma

For EPA Records Only (This information will not be posted on Web site) Name of Licensed Certifying Body Certification File Number 

Submit this form (rewriteable PDF) to WaterSense via: Fax: (703) 841-1440 Mail: WaterSense, c/o ERG, 2300 Wilson Blvd, Suite 350, Arlington, VA 22201
 

Electronically: If you have Adobe Acrobat Standard or Professional, you can complete the form electronically and e-mail it to: wa

Acrobat Reader users must print forms after completing them and fax or mail them. Contact the WaterSense Helpline at 866 WTRif you have any questions.
 

1 Please use the same name used on your partnership agreement. If you do not yet have a partnership agreement, please contact the WaterSense Helpline at (86

complete one. 

2 Product certification can apply to either a faucet or a faucet accessory. A faucet accessory is sold independently of the faucet and is defined in the specification 

discretion of the user, be readily added, removed, or replaced, and that, when removed, will not prevent the fitting from fulfilling its primary function. An accessory lavatory faucet flow restrictors, flow regulators, aerator devices, or laminar devices.” Please list the certified product and indicate the type. 

EPA Form Number 6100-15
Product 2— Faucet or Faucet Accessory 

Brand Name Model Name Model Number Type 

(faucet or faucet 

accessory) 

Flow type/Spray Pattern 

(aerated, laminar, spray, 

other) 

Ma

For EPA Records Only (This information will not be posted on Web site) Name of Licensed Certifying Body Certification File Number Product 3 — Faucet or Faucet Accessory 

Brand Name Model Name Model Number Type 

(faucet or faucet 

accessory) 

Flow type/Spray Pattern 

(aerated, laminar, spray, 

other) 

Ma

For EPA Records Only (This information will not be posted on Web site) Name of Licensed Certifying Body Certification File Number Product 4 — Faucet or Faucet Accessory 

Brand Name Model Name Model Number Type 

(faucet or faucet 

accessory) 

Flow type/Spray Pattern 

(aerated, laminar, spray, 

other) 

Ma

For EPA Records Only (This information will not be posted on Web site) Name of Licensed Certifying Body Certification File Number 

The public reporting and record keeping burden for this collection of information is estimated to average 8 hours per response. Send comments on the Agency's of the provided burden estimates, and any suggested methods for minimizing respondent burden, including through the use of automated collection techniques to Division, U.S. Environmental Protection Agency (2822T), 1200 Pennsylvania Ave., NW, Washington, D.C. 20460. Include the OMB control number in any correspcompleted New Certified Product Notification form to this address. Please copy this side and submit additional sheets as needed.